NPIMap

Individual provider Active NPI

Stacy E Smith, MD

  • Diagnostic Radiology Physician
  • Boston, MA
National Provider Identifier
1659364925
Registry record updated Oct 2, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
D0054137 Issued in MD
Practice address
75 Francis St
Radiology Brigham and Women'S Hospital
Boston, MA 02115-6110
Phone
(617) 732-7537
Fax
(617) 525-7333
NPI assigned
Aug 23, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 2, 2012

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Diagnostic Radiology Physician 2085R0202X D0054137 MD Primary

Addresses

Primary practice location

75 Francis St
Radiology Brigham and Women'S Hospital
Boston, MA 02115-6110

Mailing address

75 Francis St
Radiology Brigham and Women'S Hospital
Boston, MA 02115-6110
Phone (617) 732-7537

Other identifiers 5

IdentifierTypeStateIssuer
38110031OtherDCCAREFIRST BCBS
967707OtherMDAETNA HMO
5235541OtherMDAETNA PPO
KC46SH69762202OtherMDCAREFIRST BCBS
110800000MedicaidMD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20091005000538 MA Practitioner - Diagnostic Radiology 8628075231 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Other, 1993
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

75 Francis St
Boston, MA 02115-6110
Phone (617) 732-5500

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
D0054137MDMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Harbor Medical Associates, Inc. CurrentSince Aug 1, 2019 Accepting new patients
Harbor Medical Associates, Inc. CurrentSince Aug 1, 2019 Accepting new patients
Harbor Medical Associates, Inc. Diagnostic Radiology CurrentSince Aug 1, 2019 Accepting new patients
Brigham and Women'S Hospital Current Accepting new patients
The McLean Hospital Corporation CurrentSince Feb 14, 2020 Accepting new patients
University Imaging Center, LLC Diagnostic Radiology Past Accepting new patients
Shipley'S Imaging, LLC Diagnostic Radiology Past Accepting new patients
David L Bloom PA Diagnostic Radiology Past Accepting new patients
University of Maryland Diagnostic Imaging Specialists P a Diagnostic Radiology Past Accepting new patients
University Imaging Specialists Diagnostic Radiology Past Accepting new patients
University Imaging Center, LLC Diagnostic Radiology Past Accepting new patients
David L Bloom PA Diagnostic Radiology Past Accepting new patients

Locations

115 Mill St
Belmont, MA 02478
Phone (617) 855-2000

75 Francis St
Boston, MA 02115

541 Main St
Ste 314
Weymouth, MA 02190
Phone (781) 952-1200

541 Main St
Ste 210
Weymouth, MA 02190
Phone (781) 952-1200

Interoperability endpoints

  • Direct secure messaging: smith.stacy.bwh@direct.partners.masshiway.net

Organizations & group practices 13

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

View all 13

Hospital & facility affiliations 6

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1124755200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1349136000000",
    "number": "1659364925",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "75 FRANCIS ST",
            "address_2": "RADIOLOGY BRIGHAM AND WOMEN'S HOSPITAL",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021156110",
            "telephone_number": "617-732-7537",
            "fax_number": "617-525-7333"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "75 FRANCIS ST",
            "address_2": "RADIOLOGY BRIGHAM AND WOMEN'S HOSPITAL",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021156110",
            "telephone_number": "617-732-7537",
            "fax_number": "617-525-7333"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMITH",
        "first_name": "STACY",
        "middle_name": "E",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-08-23",
        "last_updated": "2012-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "MD",
            "license": "D0054137",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAREFIRST BCBS",
            "identifier": "38110031",
            "state": "DC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA HMO",
            "identifier": "967707",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA PPO",
            "identifier": "5235541",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAREFIRST BCBS",
            "identifier": "KC46SH69762202",
            "state": "MD"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "110800000",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Boston, MA

Sources for this page

Verify at the official NPI Registry.